Caution When Screening for Autism among Socially Anxious Youth.
Nicole N Capriola-Hall, Tyler McFayden, Thomas H Ollendick and 1 others
PMID 32770344WHAT IT FOUND
The SRS-2 parent questionnaire fails to distinguish autism from social anxiety in youth.
It misclassified many children, with socially anxious youth scoring as high as those with autism. Clinicians should not rely on SRS-2 scores alone to rule in autism.
Key findings
01Youth with social anxiety only scored similarly to those with autism only on the SRS-2 total score, meaning the test did not differentiate the two groups.
02Using the standard cutoff of 62, the SRS-2 had poor sensitivity (0.67) and specificity (0.50) for distinguishing autism from social anxiety.
0359% of youth diagnosed with social anxiety only scored above the clinical threshold for autism on the SRS-2.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was likely underpowered to detect smaller differences between groups. The sample was predominantly White (81.4%) and cognitively high-functioning (IQ 69-131), so results may not generalize to diverse racial/ethnic groups, children with lower cognitive abilities, or younger children. Data were combined from two different sources (a clinic and a research trial), which may introduce variability. The 'Social Awareness' subscale had modest internal consistency, suggesting its items may not measure a single stable construct in this sample.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret a high SRS-2 score in a socially anxious child as definitive evidence of autism. The study showed that the SRS-2 cannot reliably distinguish between autism and social anxiety, leading to a high rate of false positives where anxious children are misclassified as autistic.